- 作者：Hans-Helmut K枚nig ; Hanna Leicht ; Christian Brettschneider ; Cadja Bachmann ; Horst Bickel ; Angela Fuchs ; Frank Jessen ; Mirjam K枚hler ; Melanie Luppa ; Edelgard M枚sch ; Michael Pentzek ; Jochen Werle ; Siegfried Weyerer ; Birgitt Wiese ; Martin Scherer ; Wolfgang Maier ; Steffi G. Riedel-Heller ; AgeCoDe Study Group
- 关键词：Cost-of-illness ; dementia ; nursing home ; informal care
- 刊名：Journal of the American Medical Directors Association
- 出版年：February, 2014
- 年：2014
- 卷：15
- 期：2
- 页码：117-126
- 全文大小：280 K
Objective
To compare the costs of care for community-dwelling dementia patients with the costs of care for dementia patients living in nursing homes from the societal perspective.Design
Cross-sectional bottom-up cost of illness study nested within the multicenter German AgeCoDe-cohort.
Setting
Community and nursing homes.
Participants
One hundred twenty-eight community-dwelling dementia patients and 48 dementia patients living in nursing homes.
Intervention
None.
Measurements
Utilization and costs of medical care and long term care, including formal and informal social and nursing care based on proxy interviews. Informal care was valued using the replacement cost method.
Results
Unadjusted mean annual total costs including informal care were 鈧?9,930 ($43,997) for community-dwelling patients and 鈧?3,482 ($49,218) for patients living in nursing homes. However, multiple regression analysis controlling for age, sex, deficits in basic and instrumental activities of daily living and comorbidity showed that living in the community significantly increased total costs by 鈧?1,344 ($16,676; P < .01) compared with living in a nursing home, mainly due to higher costs of informal care (+鈧?0,585;聽+$30,260; P < .001).
Conclusion
From the societal perspective care for dementia patients living in the community tends to cost more than care in nursing homes when functional impairment is controlled for.